What department should I see for a lumbar disc herniation?

Written by Na Hong Wei
Orthopedics
Updated on September 09, 2024
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For herniated lumbar discs, you should visit either the Department of Spine Surgery or Orthopedics. The specific department depends on the hospital you choose to visit. If the hospital is a high-level institution, grade three or above, it will certainly have a Department of Spine Surgery, so this would be the first choice. However, if the hospital is a community clinic or a second-tier hospital, it might not have a Spine Surgery department, so you would need to visit the general Orthopedics department. Although herniated lumbar discs are a common orthopedic condition and can be treated in Orthopedics, visiting a specialist in Spine Surgery can often provide more expert care as these doctors may have higher levels of experience and expertise in treatment.

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Written by Na Hong Wei
Orthopedics
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What should I do if I have a lumbar disc herniation?

After a lumbar disc herniation, it is essential to first determine the type of herniation you have. Clinically, lumbar disc herniations can be categorized into protrusion, prolapse, extrusion, and sequestration, with protrusion being the most common. Once the type of herniation is identified, treatment can begin. Currently, the treatment methods are diverse and can be broadly classified into six categories. The first is internal treatment with traditional Chinese medicine. Traditional Chinese medicine classifies lumbar disc herniation into four types, each treated with different medications. The second is external treatment with traditional Chinese medicine, such as herbal fumigation and plaster application. The third is traction, which includes bed traction and manual massage. The fourth is acupuncture. The fifth category includes other therapies, starting with resting on a hard board bed for approximately a week, followed by techniques like small needle knife therapy, intradiscal injection, sacral canal injection, and ozone therapy. If conservative treatments prove ineffective, or if symptoms worsen during treatment, surgical intervention may be necessary. Surgical treatment is generally indicated in the following four situations: patients with spinal stenosis, patients who do not respond to conservative treatment or who experience recurrent symptoms after recovery, patients with worsening neurological symptoms, and patients with central lumbar disc herniation causing incontinence. These are the conditions mentioned above.

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Written by Na Hong Wei
Orthopedics
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Lumbar disc herniation has what manifestations?

Lumbar disc herniation has the following clinical manifestations. First, lower back pain accompanied by unilateral radiating pain in the lower limbs. Second, numbness in the localized area. Third, weakness in the toes. Fourth, decreased temperature in the affected limb. Upon examination, the first finding is a reduced natural anterior curve of the lumbar spine, which we refer to as a flat or board-like back. Second, it can also cause the lumbar spine to bend to one side, possibly toward the affected side or the healthy side, depending on the location of the herniation. Third, there is a fixed tender point beside the lumbar spine, which plays an active role in diagnosis and treatment. Fourth, due to pain, there is a limitation in the movement of the lower back; normally, the lumbar spine can flex 45 degrees forward, extend 20 degrees backward, and bend 30 degrees to each side. If these ranges of motion are not achievable, it indicates a significant limitation in lumbar activity. Fifth is the neurological localization examination, which primarily involves different sensory disturbances, motor disturbances, or muscle atrophy depending on the site of compression. There are also some special tests, like the straight leg raise test, reinforcement test, healthy side leg raise test, as well as the neck flexion test and femoral nerve stretch test. Lastly, additional diagnostic tests like CT or MRI can provide specific information on the location and stage of the lumbar disc herniation.

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Written by Na Hong Wei
Orthopedics
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Is there a cure for lumbar disc herniation?

Lumbar disc herniation is treatable, and the results after treatment are very good. The treatment methods for lumbar disc herniation mainly depend on the direction and degree of the herniation as well as the symptoms it causes. Generally, it is divided into conservative treatment and surgical treatment. Conservative treatment is the first approach, which initially includes general treatment. That is to say, after experiencing symptoms of a lumbar disc herniation, you must first rest in bed and then make sure to sleep on a flat bed and appropriately strengthen the muscles of the lower back. The second approach is traditional Chinese medicine, the third is traction and massage therapy, the fourth is physical therapy, and the fifth is rehabilitation therapy. If the treatment is not effective, or other surgical indications appear, such as urinary and fecal incontinence or spinal cord type nerve damage combined with spinal stenosis, then surgical treatment is needed. Surgical treatments generally include conventional surgery and minimally invasive surgery, with the latter being more commonly used nowadays. Other treatments include disc sealing, sacral therapy, small needle knife therapy, and nucleus pulposus injection with ozone, among others. Overall, not only is lumbar disc herniation treatable, but there are also many treatment methods. However, as to which treatment method is suitable for you, you must go to the hospital and consult a doctor to decide.

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Written by Cheng Bin
Orthopedics
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What are the massage techniques for lumbar disc herniation?

In clinical practice for patients with lumbar disc herniation, there are many massage techniques available. For example, active kneading, pinching, and rolling techniques can be used. The primary purpose of the massage is to relax the local muscles and promote local blood circulation, thereby easing the tension in the patient's lower back, protecting the lumbar spine better, and alleviating the clinical symptoms of lumbar disc herniation. It is best to go to the acupuncture and massage department of a formal hospital for treatment, as formal hospitals are more professional, have a better grasp of indications, and the effects are likely to be more satisfactory. Try to avoid getting massages at outside massage parlors, as excessive force or incorrect techniques can sometimes aggravate the patient's clinical symptoms.

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Written by Na Hong Wei
Orthopedics
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Where to apply moxibustion for lumbar disc herniation

After a lumbar disc herniation, if moxibustion treatment is used, there is a concept of main and supplementary acupuncture points. The main point is the Jiaji point at the herniated lumbar disc segment, accompanied by the Jiaji points directly above and below it. For example, for an L4-5 disc herniation, moxibustion would be applied to the Jiaji points of L3-4, L4-5, and L5-S1. Additionally, supplementary points are chosen based on the patient's other symptoms. If there is significant lumbar pain, the Yao Yan (Lumbar Eyes) point on the affected side is used. If there is muscle tension in the buttocks, the Huan Tiao and Yi Bian points are used. If there is tension in the back of the thigh, support would include the Fu Cheng, Yin Men, and Wei Zhong points. If numbness occurs on the outer side of the thigh, the Feng Shi point is used. For numbness in the calf, the Wei Yang, Cheng Shan, Yang Ling Quan, Zu San Li, and Xuan Zhong points are used. For numbness on the dorsum or sole of the foot, the Tai Xi, Jie Xi, and Xia Xi points are included.